Common Sports Injuries of the Knee & Shoulder James M. Farmer M.D. Sports Medicine & Orthopaedic Surgery Lewis-Gale Physicians

Overview Knee Injuries Meniscal Tear Articular Cartilage Tear ACL Tear Patellofemoral Pain Iliotibial Band Syndrome James M. Farmer M.D. 540-772-3530

Overview Shoulder Injuries Dislocation A-C Separation SLAP Lesion Rotator Cuff Tear James M. Farmer M.D. 540-772-3530

Knee Anatomy Femur and Tibia Articular Cartilage Meniscus Ligaments James M. Farmer M.D. 540-772-3530

Meniscal Tear Mechanism Signs and Sx Young: twisting or pivoting Older: minor trauma Signs and Sx Swelling Catching Giving way Locking James M. Farmer M.D. 540-772-3530

Meniscal Tear James M. Farmer M.D. 540-772-3530

Preferred Treatment Acute: Rest, Ice, Activity Modification, Surgery Meniscal tears will not normally heal without help unless very young Chronic: Surgical excision James M. Farmer M.D. 540-772-3530

Articular Cartilage Tear Mechanism Acute trauma Wear and tear Signs and Sx Pain Swelling James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Activity Modification, Pain Medications, Injections Surgical: Arthroscopic debridement and removal of lose fragments Procedures to restore weight bearing surface Resurfacing, Cartilage Transplant, Joint Replacement James M. Farmer M.D. 540-772-3530

ACL Tear Mechanism Signs and Sx Twisting Pivoting Sudden stop Acute: swelling, pain, instability Chronic: frequent giving way, pain James M. Farmer M.D. 540-772-3530

ACL Tear James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Activity Modification, Rehabilitation, Bracing Surgical: Reconstruction of Ligament Goals of Surgery: Restore normal knee stability and function. Delay onset of degenerative arthritis James M. Farmer M.D. 540-772-3530

Patellofemoral Pain Pain originating from behind the knee cap Very common condition Exact cause unknown (likely many) Signs and Sx Aching pain along front of knee Worse with sitting, stairs and squatting Giving way and buckling James M. Farmer M.D. 540-772-3530

Patellofemoral Pain James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical!!! Surgery Activity modification Physical Therapy Taping, Bracing, Orthotics Injections Surgery Not many “Good” options Arthroscopy, Osteotomy, Resurfacing, Arthroplasty James M. Farmer M.D. 540-772-3530

Iliotibial Band Syndrome Caused by tight ITB rubbing over lateral epicondyle of femur when running. Signs and Sx Sharp pain over lateral knee when running or cycling Occassional swelling James M. Farmer M.D. 540-772-3530

Iliotibial Band Syndrome James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Surgical: Stretching Physical Therapy: Ice, Ultrasound Orthotics Medications Injections Surgical: ITB release James M. Farmer M.D. 540-772-3530

Shoulder Anatomy Humerus and Scapula Labrum Biceps Tendon Rotator Cuff James M. Farmer M.D. 540-772-3530

Shoulder Dislocation James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Surgical: Acute: Immobilization, Rest, Ice, Rehab Chronic: Rehab, Meds Surgical: Arthroscopic stabilization as effective as open procedures Repair bankart lesion, tighten capsule James M. Farmer M.D. 540-772-3530

A-C Separation Sprain of joint between collar bone and shoulder blade at tip of shoulder Mechanism: Fall onto tip of shoulder Signs and Sx Pain Deformity James M. Farmer M.D. 540-772-3530

AC Separation James M. Farmer M.D. 540-772-3530

Preferred Treatment Grades 1 & 2: Non Surgical Grades 4-6: Surgical Grade 3: Debatable Non Surgical: Adequate for most Rest acutely then resume activities Surgical: Primarily for overhead athletes and military Acute: reduce and stabilize joint Chronic: Reconstruct ligaments James M. Farmer M.D. 540-772-3530

SLAP Lesion & Biceps Rupture Injuries to Biceps tendon origin in the shoulder Mechanism: Acute: sudden pull on arm. Chronic: Degenerative, overuse Signs and Sx Pain reaching upward with palm Weakness Possible deformity if ruptured James M. Farmer M.D. 540-772-3530

SLAP Lesion & Biceps Rupture James M. Farmer M.D. 540-772-3530

SLAP Lesion & Biceps Rupture Popeye Deformity John Elway won 2 Super Bowls AFTER Biceps rupture! James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Surgical: Activity modification Physical Therapy Surgical: Repair of tendon attachment Release tendon Relocate tendon James M. Farmer M.D. 540-772-3530

Rotator Cuff Tear Continuum from Impingement to Complete Tear Mechanism: Acute: trauma. Chronic: degeneration with age due to poor blood supply to tendon Signs and Sx Pain reaching overhead Pain sleeping Weakness and dysfunction James M. Farmer M.D. 540-772-3530

Rotator Cuff Tear James M. Farmer M.D. 540-772-3530

Preferred Treatment Non Surgical: Surgical: Activity modification Physical Therapy Injections Surgical: Arthroscopic or Open repair of tendon and removal of bone spurs Shoulder replacement James M. Farmer M.D. 540-772-3530